How to get better from POTS through lifestyle changes
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- เผยแพร่เมื่อ 16 มิ.ย. 2024
- POTS (postural orthostatic tachycardia syndrome) is commoner than we think. 1 in 3 people with a diagnosis of Chronic Fatigue Syndrome(CFS) or ME also have POTS. Similarly a large number of patients with Fibromyalgia probably also have POTS. In my practice, I have the privilege of managing the treatment of about 150 patients with POTS . I have found that lifestyle and behaviour change recommendations can be a very valuable and effective adjunct to pharmacotherapy in terms of both empowering the patient and helping improve overall quality of life.
The aim of the lifestyle modifications are five-fold:
To increase the amount of blood volume within the body
To minimise pooling of blood in the legs by compression or strengthening the leg muscles
To prevent further deconditioning
To minimise adrenaline surges
To correct any electrolyte, nutritional and hormonal deficiencies
Here are some of the lifestyle measures that I recommend to all my patients who have POTS . It goes without saying that you should always check with your own doctor if the following recommendations are suitable for you
Increase daily fluid intake to at least 3L of water a day. The fluid intake should be increased even more when fluid losses are higher such as during hot weather. I would also recommend drinking a couple of glasses of water first thing in the morning about 20-30 minutes before adopting an upright posture.
Minimise loss of fluid by avoiding diuretics, caffeine, alcohol, and sodas.
Increase daily sodium intake to 10-12g of sodium per day. This can be done by increasing salt intake by using more table salt on food but also by taking slow salt tablets. Salt will help retain more volume within the body. Without salt, all the extra water that is drunk will simply pass out in the urine.
Increased salt intake can be distasteful for some patients and i advise supplementing electrolytes (such as 2 sachets of Dioralyte/day in divided doses) to water.
Magnesium supplementation: It is estimated that 75% of the population is deficient in Magnesium. The Blood tests for magnesium are notoriously unreliable and therefore i usually recommend magnesium supplementation regardless of the blood test results. In terms of supplements, i advise my patients to avoid magnesium oxide but other commonly available magnesium supplements such Magnesium CItrate 200mg daily or magnesium taurate 125 mg bd work well.
Beyond water and salt the best things that happened to me is 1) understanding that PoTS won't kill me 2) Accepting I'm never going to love being vertical but learning to ignore that 3) As long as my heart rate is being monitored and I increase exercise at a slow steady pace, there really isn't any limit to how far I can go. 4) Stop being afraid. Regardless of what my nervous system is trying to tell me, I'm not really dying.
Also, the issue isn't even getting dizzy when standing up or having the heart race. It's the inability to exercise like regular people, or carry things upstairs, move furniture, and basic physical things normal people can do that are nearly impossible to do without getting dizzy and a heart rate of 180bpm
I feel your pain. I go to the library and carry books and my heart skyrockets!! I miss my old self :(
@Tara King My heart rate goes up to 140 beats just walking up the stairs at home,
@Tara King I developed pots from covid. I've been on two different beta blockers and will start Ivabradine next week,. My heart goes out to anyone who is going through this.
@@neverseenblue11 I can relate to what you're going through, as I have POTS from my Ehlers Danlos syndrome. Beta blockers made me worse, but I've heard great things about Ivabradine. Hoping it helps you. Mestinon is what worked wonders at eliminating my POTS, and I saw a good video about it from this York Cardiology channel. I also take a small nightly dose of Clonidine, which increases blood volume by preventing blood pooling and also prevents adrenaline surges.
@@neverseenblue11 How do you feel now with Ivabradin? Have you side effects and does it help you? :)
I figured things out on my own before finding these videos. Fluid in the morning is vital. Low carb. Good luck potsies
I spent 10 years asking doctors why I feel like absolute garbage every morning when I wake up. No one could figure it out until my mom told me to ask my cardiologist if it might be POTS. If it wasn’t for her, I probably never would’ve gotten a diagnosis. Nothing’s helped me so far except for getting away from stress and hot weather.
Have they tried you on Mestinon, Ivabradine, Guanfacine, Clonidine, or beta blockers? Hoping they can find something that helps you feel better.
I am so sorry for what you've been through I want to connect with you do you have Instagram?
Kori, how are you doing now?
I believe I have POTs as I've had suspected M.E/cfs for 15 years and just had a HSD and Fibro Diagnosis too. Just come back from holiday and I could barely sit in the sun, it's just too excruciating and makes me feel too faint!
Same
This was extraordinarily helpful. Finally, a doctor who exhibits some compassion for the MANY of us with this syndrome.
Yes, I wanted to hug him. When my family gets home, they are going to watch this. Maybe they'll understand better.
I felt more understood and heard watching this video than I have with any of my myriad doctors and specialists. My doctors now are compassionate, but incompetent, they have such a gross undereducation of PoTS and broader dysautonomia. Most resort immediately to pharmaceuticals and send us on our way to slip into disability. This video should be required viewing for the medical community.
Thats cause doctors are bandaid specialists not healing specialists
Or, they send you to a psychiatrist, because you must be anxious and/or making it up. And, of course, the first thing they all push is SSRIs/SNRIs, even though I have told them they cause me to have syncope. I have never understood how they think that me living alone and fainting is a good idea.
I recently went to yet another doctor looking for a diagnosis so I could get appropriate treatment. I was hoping if I went to a younger, female doctor, I wouldn't be screamed at or dismissed. She referred me to a therapist instead of hearing me. I went home and started self-management techniques (salt/electrolytes) for PoTS, and I was free of palpitations (which they have been telling me are panic attacks, even though they last for up to 12 hours every day) for the first time in decades. I'm looking forward to becoming more active after not being able to walk to the store without knocking over displays and having to lie down on the ground, soaked in sweat, on the way home.
I wish I hadn't lost so many years, opportunities, and relationships to this disorder, but I have hope now that my quality of life will improve.
Please bring awareness that men get this too!
Yes!!! Everyone in my support group is woman. While it’s rare, us men get it also!
@@sadkfjasdkl4543 there is a FB group for men. Look up POTs men
Yessir!
I am a male who has battled POTS for most of my life, due to being born with hypermobile type Ehlers Danlos syndrome. Thankfully Mestinon and a small nightly dose of Clonidine has treated my POTS really well, but I had decades of it going untreated which was very debilitating and unpleasant.
@@IlIKRATOSIlI yeah and it less than 30 guys
Exercise, now that I'm able to do it, has been the BEST thing for my POTS. It seems to be regulating my heart rate. It doesn't spike as much over every little adrenaline surge. And increasing my circulation and blood volume via exercise has helped more blood get up to my brain giving me less pre-syncope symptoms and a lower heart rate overall. As long as I stay hydrated and avoid heat and alcohol, my POTS is very well controlled now. I can even shower standing up again!
Ja Ba No, Thankfully I've not needed any medicine to get to this point.
My main issue is being able to even exercise. How'd you exercise without getting lighheaded?
@@eddie8489 Exercise lying down, 90 percent of exercises have a lying down variation. I have POTS too and im just starting Midodrine and im yet to find out if it will benefit me.
I weightlift and do cardio lying down because exercising standing up is almost impossible when u have POTS, and dont even risk it cos losing consciousness while ur holding barbells or dumbbells is NOT safe.
@@jasperp.5357 great tips!
@@jasperp.5357 did the medicine ever help?? And I have no clue on how to workout laying down let alone doing cardio & such. Did you happen to find videos on it ?
I wish all doctors were like you. The fact that you write letters for your patients, speaks volumes. Thank you for your kindness towards patients. You are the definition of what a medical doctor should be.
I find swimming very helpful. You are horizontal in the water and the water exerts some compression throughout the body. I always feel better when I swim & POTS does not bother me while I do it.
That's good!
Me too. Just be careful getting out, and also hot showers afterwards can instigate symptoms
Such a relief when you find a Doctor who is highly knowledgable
Indeed. Just wish I could see such a doctor in person.
Hula Hooping has changed my life its my go to Therapy, I was bedridden immobile with terrible deconditioning and following all the necessary lifestyle changes I needed a movement for core strength and short intervals so I learnt at 44 & it's been the best thing and I may never have came across or thought it even possible until I read of someone with pots using it as Therapy and rehabilitation with sucess 🙌🙌
How high does your heart rate get when you hula hoop? How does it make you feel? How did you start doing it, like 5 mins Day then increase?
What a lovely human being- it's so good to be reminded that there are Doctors out there who truly care, and just want to help/heal their patients. The information in this video is also superb: Hippocrates would have been proud methinks!! Thank you Doctor :)
My downside of POTS- constant thirst, hunger & fatigue (also getting dizzy, sick to my tummy, etc etc). The things that have helped me tremendously- 1. Saline Therapy (IVs) 2. Exercise (when I can do it) 3. Salt tablets 4. Trying to cut out carbs as much as possible 5. Gabapentin 6. Compression socks!
Hey girl! So cool to see a fellow spiritual divine feminine on here :) your comment gave me so much relief as I too have the exact same symptoms as you and I do all the same methods as you that have also helped me a lot! Praying for you and hope you’re healing well namaste 🙏🏼✨🤍😌
La gabapatina para que sintoma seria
Where do you go for saline therapy? What kind of salt tablets? I do take gabapentin at night and wear compression socks too. I always feel so off.
@@daniellatrueselfmeditationwhat are you doing please tell me
Compression socks make my symptoms twice as bad
Thank you so much for addressing this issue. POTS has taken my life as I knew it away from me. One issue that I don't hear very much about is the extreme brain fog that can come from standing up. When I had my tilt table test done, the doc asked me how I felt after the table went upright, and I literally couldn't answer because I was so confused. It's a huge problem for me. Yes, dizziness is unpleasant but not being able to think when you are standing up or even sitting up is a very difficult life situation to navigate. I also get Raynauds in my feet and hands. I take Adderall for brain fog and extreme fatigue even though it increases my heart rate. There are no easy answers.
I feel this in my soul. The brain fog was always just as debilitating for me as the more physical symptoms like dizziness and fatigue. It was so maddening and upsetting to go from really good grades at school to struggling to even read a single page as I just couldn't concentrate.
Please please look into the medical medium. You’ll find all of the answers you need.
I was just about to write the same thing
My POTS, Raynaud's and ADHD symptoms were resolved with ultra-high doses of injected methylcobalamin. Those symptoms turned out to all be related to my body not absorbing B12 properly. I suffered for years and saw so many doctors who never suggested B12 to me. I only discovered this solution because I was eventually diagnosed with pernicious anemia and chronic mycotoxin exposure, which can alter the metabolism of B12 in the body.
Wow, best thing I've heard so far!!! Thanks much!
Thank you so much for taking time to make this video it has definitely given me hope
Great information & presentation Dr. Thank you again!
Thank you for sharing your knowledge! This has been very helpful for me.
You are the best pots doctor in the world. I am born and raised in New York City, and no one here has ever treated me the way you speak of the way you treat your patients, and from New York to Florida I have seen countless cardiologists and having gone through a really bad Potts flare post having Covid now after having pots for 11 years and not needing any medication being able to get back to my athletic job, getting Covid sent me back eight years and I found your TH-cam during that time and you truly are a leader and pots. Thank you for being a doctor to all of us who don’t get the care we deserve and need.
I love this guy too, he has mentioned another of the world's leading POTS experts who is living in the US, Dr. Blair Grubb (in Toledo OH) My daughter has been under Dr. Grubb's care. Try to get in to see him (although I know wait times get very long)
Thank you for explaining this, Dr! I hadn’t heard of this until a few years ago.
Thank you so much for these tips and for the explanation!
Thank you so much for posting this video. It's so helpful!
Thank you so much doctor for your helpful tips and your sensitivity!
Good video. I am glad he talked about the adrenaline surges.
Thank you so much, Dr. Gupta!👍👍
Brilliant and useful info! Such sanity for anyone who's spent decades seeing doctors and specialists and begging for help.
The bottle visual is so helpful. Great video, thank you
Best description yet. Thank you for breaking it down and not making it sound so scary
Thank you, Doctor. I will apply all of these measures.
Your so understanding!! 😢 Wish everyone around me thought the way you do. Thank you so much for making videos!
This is so amazing. Thank you.
Great video! Easy to understand, and gave tips that a person can try right away.
Thanks very much.
I got diagnosed for POTS after i took the bloody vaccine. I had palpitations immediately after taking the shot and continued on and off for a month, ekg, echo troponin and what not. Then finally one cardiologist said its POTS. My life has never been the same.
Same here.
Wow sorry to hear that. My niece seems to also has POTS symptoms butnis awaiting diagnosis. How are you feeling now? With her we are also suspecting its after the vaccine. Her issues started 3 days after getting the shot. How are you managing now?? All the very best!!
Same here but I don't yet have a diagnosis. Haven't been able to work or live well for nearly 15 months. Doctors think it's in my head. I have nerve pain and fasciculations too. Trying again with GP next week showing them a 10 minute stand test. Wish me luck! 🤞
You will recovery Mo eventually. The Prognosis for males and post viral pots is very good.
@@TheBushRanger. i hope so, thanks for your kind words.
Awh thankyou Sanjay so much... your caring nature and demeanour always comes across every time. Thankyou . Xx 😘
You are amazing Doctor. I am so grateful for this information. Heart felt thank you 🙏
This was probably one of the better videos I have seen on POTS. Thank you.
This is the best explanation and tips on TH-cam that I have watched so far. Thank you dr.
Thanking for giving a name to the adrenal surges!!
Sums up the off putting experience so well!
Thank you Doctor for all the videos upload for Healthy life, stay blessed 🙏
I'm so grateful for your passion to help us. So many providers dismiss us.
you have empathy and you listen to your patients these are very rare qualitys today so yes thanks for giving your time and advice 🙏💕
FINALLY A DOCTOR WHO GETS IT!!!! 🔥🔥🔥🔥🔥🙏🙏🙏👏👏👏👏👏
Thank you so much for talking about this issue with compassion. It makes all the difference in the world
Wow! Who knew anyone actually cared. I wish you were my doctor. I am just so thankful for your video.
Thank you Dr.Sanjay for this extremely useful informations
Thank you for another great video.
🙌🏻
What an immensely helpful video. Thank you so much.
Hi Dr. Gupta, It just ‘goes to show’ how some doctors really do listen to what their patients are saying to them. And trying to help them understand better and cope with their debilitating conditions, no matter how difficult it maybe, is a bonus. Good on you, all the best.
thank you so much for every word !! I could help you enough!!
for 14 years I struggle with symptoms like this. I even did Tilt test but no adequate therapy. i hope this changes in life stile would help. I wish you all the best!!
Have they tried you on Mestinon, Ivabradine, Guanfacine, Clonidine, or a beta blocker? Hoping they can find what works best to help you feel better.
Thank you so much doctor for this video. You have shed a beam of light that has answered so many of my concerns and even brought explanations to symptoms I didn't even know were symptoms because I thought everyone experienced it and it was normal. I will be speaking to my doctors to see if they recommend your suggestions for me. God bless you.
oh my goodness. you just described my life.. writing from an exhausted prone condition from my bed.. just to see the diagnosis and validate my symptoms reduces sooooo much stress. blessings..
have been misdiagnosed for yearsin cluding grrrr.... conversion disorder.. horrible horrible..affected my life with a complete turnaround from who I truly am.. finally found a wonderful neruologist who has sorted through with the correct bloodwork. now have hope but disappointed in the length for recovery.. thanks for talking about this.
You're a brilliant doctor, the way you just described things was really perfect, thank you🙏.I wished you were my cardiologist. I've had POTS like symptoms since having 2 stemi heart attacks/2stents at 30 & 32. It's been so debilitating, isolating & a living hell. I've had so many tests, but they can't figure it out. I'm so glad to come across your video, you might have saved me from having an unnecessary AFib ablation.
Thank you for your compassionately proposed and helpful advice. Did not know I was taking the wrong kind of Magnesium (Oxide). I will change next I buy. Always a relief to see a doctor talk compassionately to us POTS patients. We’ve been through it.
This is incredibly helpful. I’m going to share with all of my POTS patients!
Love the explanation with the water bottle. Thank you again Dr. Gupta for another excellent video. You taking the time to educate us is unmeasurable.
I’ve never felt more seen/validated after watching this video and reading everyone’s comments. I’ve had a lot of these symptoms for about a decade but they’ve worsened in the last 2 years and have been absolutely debilitating for the past 6 months. My doctor recommended this video and I see a POTS specialist to confirm in a few weeks. It’s crazy how you eventually convince yourself it’s just you, it’s in your head, it’s because you’re not eating perfect. It was really amazing to hear that not only are my symptoms valid and real, so many others suffer with the same!
Thank you, thank you, thank you. I am crying just because you understand! Your explanations are so helpful and your suggestions too. Thank you!!!
@FlyHigh Omg watching this video the tears just started only a short time in the video then by the end has me so emotional I feel like finally a doctor finally understand what people with pots have to go threw finally after 5 years I finally found a doctor that gets it 😭😭😭😭 I finally feel like I’m not alone in all this 🥰🙏🙏🙏🙏🙏🙏
I am so grateful to you for your thoughtful recommendations and I respect the way you acknowledged the psychological and sociological impact of POTS
By far the best video on this topic thank you so much 🙏❤️
You're level of compassion makes me want to cry 🥲
This is great information. Thank You!
Thank you for your help. I’m a big believer in helping ourselves and the only way we can do that is by educating ourselves and self discipline. Have a great day.
You are amazing! Thank you for understanding wow
Thank you so much for your kindness and understanding. If only we could clone you and your knowledge and spread it around the world ! ⭐️
Wow, this is good information. Thank you. The Mayo Clinic said compression stockings aren't as effective as a binder which compresses your core.
Thank you so much for this!! I just got diagnosed with Pots after over 10 years of searching. I appreciate the work that you are doing so much. You are right on as far as how we feel! So validating and encouraging to be believed.
I was just diagnosed after 10 years are you getting better?
Fantastic, educational video presented in a professional and compassionate manner 🙏
Thank you so much! I wish I had a lovely doctor as you are ❤️💗💕
Thanks to Dr Gupta I had a major improvement in last nights sleep and and am encouraged to continue trying to improve my lifestyle habits 😃
Thank you so much Doctor, God bless you... Informative as always 😊😇🙏🌹💐
Thank you... I had no idea something like could even happen. I'm now mostly bedridden, unable to be up for very long or look at techie most of the time. I've lost my job and I thought this was it. Finally got a diagnosis by a Physiotherapist dealing with Long Covid. Thank you for sharing this information with us! It's given me something I can work towards. All the best to all of you going through this ❤️
Thank you doctor this video is so helpful I've been dealing with all the symptoms you mentioned and I've been to multiple doctors and they told me different but watching your videos❤ really help me figure out what's going on God bless you for all that you do for your patience I will be following you for more advice thank you very much
Thank you so much for this. Really helped in explaining the mechanism to my partner. I now can't unsee upright people as shaking squeezing waterbottles though
It is good to see there is good Doctors. not only recommending chemical drugs but natural alternative advise.
Thanks for the reminder.
Best POTS explanation video I have seen ☆☆☆☆☆
Very informative thanks for sharing!
Thanks for this video. I shared it with my loved ones.
Dr.Gupta. You are a true healer, with the education and compassion to back you up.Thank you very much for your loving heart.
I love his heart ♥
What a wonderfully empathetic Dr, who clearly has a huge understanding of the syndrome, with useful input for many of us out there struggling with gaslighting, and misinformed ideas.
Thank you Dr Gupta
Thank you SO MUCH for your videos!!!❤
You are simply marvelous: I have ME CFS after catching Glandular Fever 28 years ago. 3 years ago I said to my doctor could I have POTS and it was dismissed right out: U have complained several times of heart rate falling drastically when I sit, scary irregular heart rate if I'm standing and feeling pretty good if I lie down. I finally bought a BP monitor and did several NASA Orthostatic Tests and my HR increases when standing by between 32 to 50+ so hopefully the doctor will take my question seriously tomorrow.
Very interesting! I just found out I have EDS and I suspect I have pots as well. Today is one of those days when I feel pretty crappy, but I'm glad there's things I can do to improve things :)
Thank you so much for this! Wonderful that there ARE medical professionals out there who believe in, empathise with and most importantly support their patients! ☺
Yeah but good luck finding one for yourself
@@no_country_for_real_men sad but true... still nice to know they exist 🙂
@@donnawilliamson277 they are a needle in a haystack in the u.s. A country where people with medical degrees are a dime a dozen but 95% are not educated, skilled nor true professionals.
I felt seen watching this. Why aren’t more doctors educated on this? I’m 31 and started having symptoms in my early 20s. Doctors ran tests and thankfully everything came back negative so their next thing was you have panic disorder. Thankfully the low dose beta blocker they gave me also helps with pots. I wouldn’t wish this on anyone. Thanks Doc for all you do. I cried the first 5 mins of the video when you described how it feels. I also notice my symptoms come in waves. I can go months and be fine. I do agree on the adrenaline rush. I remember a primary doc told me maybe you just produce a lot of adrenaline and dismissed me. It good to have the medication AND the information on this.
What do your adrinline rushes feel like? Like hot or cold feet runs up your legs. A irration feeling. I also get burning in my chest especially laying on my back. It just burns away.
I have been dealing with this for 3 years and this is the best visual explanation I have found so far. Thank you! My mom is 79 and going through this and now I will have an easy way to explain it to her as well. She can’t wear compression socks because of how it squeezes the neuropathy in her feet causing pain, but vitamin B1 is starting to help so far. Thank you again for this! 🙏🏾
You are so good.
Thank you for your knowledge and time it means alot .
my significant other has pots and iv been trying to learn about it and this video has helped alot thank you
Sanjay you are inspiring. It’s such a rewarding condition to treat isn’t it! When I’m better I’m going to learn from you. Fellow medic with Long COVID ME and PoTS
You good now Asad?
You seem to be such a kind and empathetic doctor! I wish I could find a doctor like you in Belgium. Thank you for this video to help us dealing with POTS.
I know what you mean I can't find one and I live in the u.s.
So thankful for this information ❤
Doc you are wonderful. I developed POTS after a vertebral artery dissection (I have Vascular EDS). It has made getting back to work very difficult but I am hopeful and following the advice here.
Hi, did u recover from pots?
Any advice for improvement, i'd really appreciate.
Thank you so much for these videos it has been so helpful, I had COVID in Aug 21 and was making a slow recovery but then in Feb 22 I started to feel worse again and then I couldn’t get out of bed without my HR elevating, feeling dizziness , nausea, pins and needles, breathless and extreme need to sit or lay down, my Dr said they are hearing of a lot of POTS symptoms following COVID and so I am learning about it while I wait on a referral to a cardiologist for an official diagnosis and treatment.
Have zero expectations out of amERRORican doctors. They are worthless. I have the same issues as you and I have bad news - you are going to have to figure it out on your own because I guarantee you they won't correctly diagnosis you let alone treat it. When it comes to your health in the united states you're on your own.
Thank you very much, Dr. Gupta. Your information ist very helpful.
Thank you so much for this information I will try to do as doctor says.
This is an excellent video for anyone dealing POTS and also with other kinds of of dysautonomia. This guy seems like a caring, thoughtful and knowledgeable doctor-- if only they all were so good. I'd add from my experience, that drinking a Gatorlyte packet in the morning really helps a ton. Also, Lexapro or some sort of SSRI has helped with depression but also with POTS-related stomach/gut issues as well.
Amazing video. Thank you so much
Thank you so much for watching daisy. It'd mean a tonne to me if you'd consider subscribing to the channel - Sanjay (and bluebell).
@@YorkCardiology of course. Subscribed and shared!